Provider Demographics
NPI:1164016150
Name:VAZQUEZ, BRANDAN (LPC)
Entity Type:Individual
Prefix:
First Name:BRANDAN
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 TAYLOR ST STE F
Mailing Address - Street 2:#1029
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-3973
Mailing Address - Country:US
Mailing Address - Phone:832-205-8390
Mailing Address - Fax:
Practice Address - Street 1:1919 TAYLOR ST STE F
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-3973
Practice Address - Country:US
Practice Address - Phone:832-205-8390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90945101YP2500X
DCPRC15434101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional